Japanese measles epidemic brings campuses to standstill

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A rampant measles epidemic has infected hundreds of Japanese
students and frightened Tokyo universities and schools into sending
more than 160,000 students home.

In just a few days the highly contagious illness has spread
virulently from Tokyo to outlying areas, affecting potentially
thousands of people in their late teens and 20s.

The epidemic, believed to be Japan's worst in at least five
years, has brought campuses to a standstill for more than a week.
An unknown number of people have been hospitalised.

On Sunday, Tokyo's Hosei University announced it was closing a
second of its three campuses for eight days after 14 students were
confirmed to have the illness. The university closed another campus
last Thursday.

About a dozen universities in the Tokyo area, together with a
handful of other schools around the country, have suspended classes
since mid-April because of measles outbreaks, according to media
reports.

The National Institute of Infectious Diseases (NIID) said 623
people are known to have contracted the illness between February 27
and May 27, compared to only 18 during the same period last
year.

The reasons why this year's outbreak has been so severe were not
immediately clear. The Asahi Shimbun newspaper, citing
unidentified experts, said a previous decline in the number of
measles outbreaks may have lessened the efficacy of childhood
vaccinations among the students, as exposure to the virus
strengthens their effect.

NIID said April to June were likely to be peak months for the virus
to spread because of the concentration of graduation and
matriculation ceremonies during that time.

The Japanese school year ends in March and resumes in April.

Health authorities are stunned at the rapid spread of the
illness, which usually affects infants and only rarely strikes
people in their 20s and older. Most Japanese in that age group have
only been vaccinated once.

Yoshinori Yasui, chief researcher at the NIID, said the problem
was that "young people are considerably active during the
incubation period between infection and the appearance of the rash,
helping the virus to spread widely".

Measles is passed on by coughing and sneezing. It causes
pneumonia in one out of 20 cases, and brain inflammation and death
in one out of every 1000.

Japan is the only developed country to still experience large
measles epidemics. The US, which introduced a double vaccination
program in 1989, and Australia, which phased in a booster shot for
measles from 1994, have largely eradicated the disease.

In Japan, however, the government bowed to strong public
pressure in 1994 by repealing laws that made childhood
immunisations mandatory. In 2000 there were an estimated 200,000
cases of measles and 88 deaths.

It was only last April that the National Institute of Infectious
Diseases introduced a double vaccination program. But it would take
at least a decade before the results of that could be seen,
predicted Tatsuo Kato, president at the National Centre for Child
Health and Development.

The US Centers for Disease Control and Prevention has described
Japan as a "measles exporter", because it brings the illness into
the US more frequently than any other country.

In an editorial this week, The Asahi Shimbun called on
the government "to show that it is committed to eliminating measles
from this country" and "ridding Japan of the 'measles exporter'
status as soon as possible".

"In a survey conducted last autumn, the inoculation rate for
1-year-olds was adequate, but the rate for the second shot was
quite poor. It is necessary to make people, particularly parents,
aware of the necessity and importance of double vaccinations."

In Tokyo, Waseda University suspended almost all classes for
more than a week and sent home 55,000 undergraduate and graduate
students when 30 people were diagnosed with measles. Nihon
University ordered 27,000 students home until the end of next week
after 91 students contracted the disease. More than 10 other
campuses have also shut their doors.

By last Friday almost 300 students at 104 Tokyo schools were
diagnosed with measles, forcing the closure of nine schools. The
number of students affected is now believed to be considerably
higher.

The illness is spreading to outer areas, such as Chiba, where at
least 350 university and school students have contracted it, and
Saitama, where a university has reported cases among its
candidature.

The World Health Organisation aims to eliminate measles from the
Western Pacific area, including Japan, by 2012.